Targeted acupuncture may offer women with major depression a safe and effective alternative to antidepressant medication, new research suggests.

Investigators at Stanford University School of Medicine in California found that women with major depressive disorder treated with depression-specific acupuncture had a 63% response rate after 12 sessions compared with a 44.3% response rate in 2 combined control groups who were treated with either acupuncture not known to help alleviate depressive symptoms or Swedish massage.

"Pregnancy just by its nature can bring out some underlying psychiatric and emotional issues ... but treatment of depression during pregnancy is critically important so that a woman can maintain her sense of well being and take good care of herself, her fetus and, someday, her child," study coauthor Deirdre Lyell, MD, Stanford University School of Medicine, said in a statement.

Led by Rachel Manber, PhD, the study was published in the March issue of Obstetrics & Gynecology.

Response Rates Significantly Higher

For the study, investigators randomized 150 women whose pregnancies were between 12 and 30 weeks of gestation and who met Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria for major depressive disorder and who scored at least 14 on the 17-item Hamilton Rating Scale for Depression.

Of the 141 women who eventually entered the study, 52 received depression-specific acupuncture, 49 received control acupuncture, and 49 others received Swedish massage.

Treatments were provided twice a week for the first 4 weeks and then weekly thereafter for 4 additional weeks, with each session lasting about 25 minutes.

The investigators found that response rates were significantly higher in women who received depression-specific acupuncture than for either control group. Response rates in women randomized to the 2 control interventions did not differ significantly from each other at 37.5% for the control acupuncture group vs 50% for the massage group.

On the other hand, remission rates did not differ significantly between women who received depression-specific acupuncture at 34.8% and the combined control groups at 29.5%. They also did not differ between those assigned to the control acupuncture group at 27.5% or the massage group at 31.2%.

Thirty-three of the study participants discontinued treatment before the study endpoint, 30% of them for reasons related to the pregnancy. Some women in both acupuncture groups reported transient discomfort at the point of needle insertion, and 1 woman experienced bleeding at the needle site.

Significantly fewer women who received massage reported any adverse effects compared with the 2 acupuncture groups.

Clinically Meaningful

The study authors point out that the benefits observed with depression-specific acupuncture can be considered "clinically meaningful" when assessed in a broader context of depression studies.

Although there are no randomized controlled trials of antidepressants being used during pregnancy, 1 randomized controlled trial found that interpersonal psychotherapy produced a 52% reduction in Hamilton Rating Scale for Depression scores and a 19% remission rate after 16 weeks of therapy, to which the currently study compares very favorably.

According to the study, antidepressant use during pregnancy doubled between 1999 and 2003, but many women are reluctant to take these medications because of safety concerns. In fact, in this particular study, 94% of the women involved expressed reluctance to take an antidepressant because of their pregnancy.

"Because theres this concern about medication among pregnant women and their physicians, its important to find an alternative," said Dr. Manber.

Results from this study therefore suggest that this standardized acupuncture protocol could be considered a "viable treatment option" for depression during pregnancy, the investigators conclude.

Michael Thase, MD, University of Pennsylvania School of Medicine, cautions that findings from this study are preliminary, although they suggest that depression-specific acupuncture may have value in major depressive disorder in this patient population.

On the other hand, another study assessing depression-specific acupuncture in a broader population of men and women with major depressive disorder failed to find a significant effect from the modality, so evidence supporting acupuncture for the treatment of major depressive disorder is not consistent.

"Still there is reason to be cautious when prescribing antidepressants in pregnancy, and one has to weigh the pros and cons of using an antidepressant on an individual basis, he told Medscape Psychiatry.

"If these promising findings are confirmed, it would be good to have another option to complement the focused forms of psychotherapy which are currently used for antenatal depression," he added.

The study was funded by the Agency for Healthcare Research and Quality. The study authors and Dr. Thase have disclosed no relevant financial relationships.

In the 1992 presidential
campaign, Bill Clinton was a heavy underdog to popular incumbent George H. W.
Bush. Bush was considered unbeatable due to foreign policy successes including
the end of the Cold War and routing Saddam Hussein in the first Gulf War. But
Bushs approval ratings, which had been in the 90 percent range, began to dip as
his campaign ignored the economic recession. Clintons campaign manager James
Carvilles now famous campaign slogan, "Its the economy stupid," helped turn
the tide and Bill Clinton became the forty-second American president.

Just like George Bushs 1992
presidential campaign, todays medical community continues to promote the
medical myths associated with cholesterol while ignoring the real cause of
cardiovascular disease, inflammation.

Conventional opinion and
current medical dogma holds that low cholesterol, especially low LDL
cholesterol, reduces the risk and incidence of heart disease and stroke. This
belief is so entrenched in the medical community that the FDA now approves drugs
to prevent heart disease, as it did with Zetia and Vytorin, solely on the
evidence that they lower LDL cholesterol levels. Zetia has never been proven to
reduce heart attacks, strokes or death. Statin drugs help reduce the risk of
heart attack and stroke for those whove already had a cardiac event (one
percent over placebo) but fail to reduce death in women, the elderly, men over
the age of 47, and in men without cardiovascular risk factors.

A 2006 study in The
Archives of Internal Medicine looked at seven trials of statin use in
nearly 43,000 patients, mostly middle-aged men without heart disease. In that
review, statins didnt lower mortality.

Nor did they in a study known
as Prosper, published in The Lancet in 2002, which studied statin use
in people seventy and older. Nor did they in a 2004 review in The Journal of
the American Medical Association, which looked at thirteen studies of
nearly 20,000 women, both healthy and with established heart disease.

Despite a growing voice of
reason, which became even louder after the recently released Enhance study, the
cholesterol zealots continue to view cardiovascular disease with tunnel vision.
This myopic vision fuels the cholesterol drug war which rages on as each
pharmaceutical company seeks to gain economic gain in the 40 billion dollar a
year lipid lowering drug market.

In an attempt to take on the
cholesterol Goliath, Pfizers Lipitor (10 billion dollars in sales annually),
Merck and Schering-Plough combined their cholesterol lowering drugs, Zocor and
Zetia, to form the "super drug" known as Vytorin. Vytorins goal was to lower
LDL cholesterol more than either drug could alone. Zetia lowers blood
cholesterol by blocking the absorption of dietary cholesterol from the
intestines. Zetia used alone is modestly effective in lowering LDL cholesterol
by approximately 17 percent. Zocor alone lowers LDL levels by 36 percentsimilar
to Lipitor.

The hope was that by lowering
LDL to dramatically low levels, Vytorin would do a better job of slowing the
accumulation of fatty plaques in the arteries. Vytorin did, in fact, reduce
LDLby a whopping 51 percent (similar to AstraZenecas Crestor).

However, the two-year
"Enhance" trial failed to prove that Vytorin is better than Zocor alone for
slowing plaque accumulation; instead atherosclerosis worsened in those taking
Vytorin.

Merck and Schering-Plough
suppressed this finding for twenty months.

The study results were not
revealed until the two drug companies were pressured into doing so by an article
in The New York Times and a Congressional inquiry. The marketers of
Vytorin said they had nothing to hide. Its hard to believe they werent just a
little reluctant to publish their highly anticipated study. The news that
Vytorin, which retails for $100 a month and did $2 billion in sales in 2007, was
clinically inferior (perhaps even dangerous) to generic simvastatin (statin),
costing less than $20 a month, obviously wasnt what stockholders wanted to
hear.

Merck and Schering-Plough are
running full-page ads daily in the Times and Wall Street
Journal, warning people not to be confused by a single study and to
continue taking Vytorin. The advice was backed by the American Heart
Association, which the Times reported receives nearly $2 million a year
from Merck/Schering-Plough Pharmaceuticals.

Other LDL lowering drugs have
bitten the dust in the last coupe of years as well.

Pfizers trial of its
much-anticipated drug torcetrapib, which raised HDL, the good cholesterol, and
lowered LDL, had to be stopped in 2006 because the drug caused heart attacks and
strokes.

Estrogen replacement therapy,
which is known to lower LDL cholesterol levels, failed to reduce the incidence
of heart attack and stroke in clinical studies.

Ok, if cholesterol lowering
isnt the answer for everyone, why do statins help people with existing heart
disease? Dr. James K. Liao of Brigham & Womens Hospital in Cambridge,
Massachusetts, has been investigating this question for over a decade. He
suspects that statins have other biological effects. His research shows that
statin drugs not only block cholesterol, but also an inflammation-generating
enzyme known as rho-kinase.

When Liao reduced the
rho-kinase levels in rats, they didnt get heart disease. "Cholesterol lowering
is not the reason for the benefit of statins," he concludes. Of course, there
are dozens of inflammatory chemicals that play a role in triggering
cardiovascular disease. Diet, health habits, our environment, even our
personality may initiate inflammatory chemicals that perpetuate cardiovascular
disease events.

Ralph Waldo Emerson once said,
"People see only what they are prepared to see." As the evidence about
inflammation and cardiovascular disease rises, will conventional medicine and
the public at large be prepared to see that its not about lowering cholesterol
but in reducing inflammation? Hopefully, "Its the inflammation, stupid," will
become a common slogan in the campaign to fight cardiovascular disease.

Rodger Murphree, D.C., has
been in private practice since 1990. He is the founder of, and past clinic
director for a large integrated medical practice, which was located on the
campus of Brookwood Hospital in Birmingham, Alabama. He is the author of
Treating and Beating Fibromyalgia
and Chronic Fatigue Syndrome, Heart Disease What Your Doctor Wont Tell You,
and Treating and Beating Anxiety and Depression with Orthomolecular
Medicine. He can be reached at www.treatingandbeating.com, by email at
drrodgerm@yahoo.com or 1-205-879-2383.

LIVE LOVE LAUGHEvery day can be filled with meaning. Take a moment, just the amount of time you need to take a deep breath and exhale slowly, to ask yourself what is my dream, and how will I get there from here?What can you stop doing or do differently to simplify your life and make it more meaningful? What is truly important to you? Do you give some time each week to your true priorities?Why not fill your life with love and laughter whenever you can? There is no greater gift than the gift of loving others. There is nothing wrong with taking some time for self-care too. Love your pet? Love walking out in nature? Make time for your passions and those things that add value to your life. Your body, mind and soul will thank you.Do you have a mission in life?Dream it. Think about it. Talk about it. Commit to it.

Athletes would agree the ability to know the precise
position of their extremities and joints in space are essential to optimal
performance. Playing tennis, hitting a baseball and swinging a golf club are
just a few examples of where this is critical. New research indicates chiropractic
adjustments can significantly improve joint position sense in those with a
history of neck pain who currently are asymptomatic. In the recent study, asymptomatic
subjects with a previous history of neck pain significantly improved their
elbow joint position sense immediately following a chiropractic adjustment to
the neck. While only the position sense of the elbow was evaluated in this
particular study, it's not a stretch to assume other parts of the upper extremity and potentially lower extremity could also be positively affected. This could be very significant for those wishing to achieve optimal athletic performance in a number of sports.

It was previously
widely believed that those with a pear-shaped figure were less at risk for
developing heart disease when compared to those with an apple-shaped figure.
However, a new study has found that the shape of one's body does not have any impact
on their risk for heart disease. Rather, the risk for heart disease is based
on one's BMI (body mass index) and specifically having a body mass index of 30 or
more, regardless of one's body shape. BMI is determined by dividing one's weight
in kilograms by one's height in meters squared. The 10-year long study was based
on 220,000 people and involved almost 200 scientists from 17 different
countries.

According
to a review of research published by the Cochrane Collaboration, an
international organization that evaluates medical research, zinc supplements
appear to shorten the length of colds by approximately one day as well as
lessen the symptoms. Their findings are based on based on 13 trials with close
to 1,000 participants who either took zinc or a dummy treatment at the
beginning of their symptoms. Two other trials indicated zinc helped stave off
colds, but the research quality of the studies were considered poor. Exact zinc
dosage and formulation for optimal effectiveness is not known, nor is the
mechanism of how zinc reduces the length and symptoms of colds. It should also be noted that
taking zinc over a long period of time should be done carefully as it can interfere
with other metals in the body resulting in unpredictable consequences.

Nearly 500 chiropractic physicians, students and supporters converged on the nations capital Feb. 14-15 as part of the American Chiropractic Associations 2011 National Chiropractic Legislative Conference (NCLC) with the Chiropractic Summit. Those in attendance listened to speeches from government leaders, received advocacy training and urged elected officials to support pro-chiropractic measures that seek to provide patients, veterans and active-duty military personnel with greater access to the essential services provided by chiropractic physicians. While last years conference focused on the first phase of health care reform, congressional debate surrounding the Patient Protection and Affordable Care Act (PPACA), this years meeting concentrated on the next phase, implementation of the law. Among the speakers this year, Iowa State Sen. Jack Hatch (D-Des Moines), a member of the White House Legislative Working Group on Health Care Reform, stressed that while the work being done on Capitol Hill to expand patient access to chiropractic care is vital to improving health care for all Americans, at this stage important work is also being done in every state capital. This is both a challenge and an opportunity, he said. The meetings keynote speakers were Sen. Tom Harkin (D-Iowa) and Ret. Brig. Gen. Becky Halstead, spokesperson for the Foundation for Chiropractic Progress. Harkin, who was instrumental in the inclusion of the provider non-discrimination language in PPACA emphasized chiropractics role in transforming the U.S. health delivery system. Patients want options, alternatives and noninvasive care said Harkin. We need to keep moving forward, away from the current sick care system to a health care system. Chiropractic physicians must be a part of the health care team. Halstead, a fierce advocate for chiropractic care for our nations veterans and active-duty military talked about prescription drug addiction in the military as a result of rampant chronic pain. She cited a recent USA Today newspaper article about another generals struggle with addiction and back pain, cautioning, If its happening in leadership, its rampant at lower levels. Halstead then shared her personal struggle with fibromyalgia and chronic pain, which was finally resolved through chiropractic care. If I had had more access to sustained chiropractic care [when I was in active duty], I would probably still be in the military, she said. Also on behalf of the nations Armed Forces, Rep. Michael Rogers (R-Ala.) urged attendees to ask their congressional representatives to support H.R. 409, the Chiropractic Health Parity for Military Beneficiaries Act, which would require the U.S. Secretary of Defense to develop a plan to allow any beneficiary covered under TRICARE to select and have direct access to a chiropractic physician. Rogers recently re-introduced this legislation in the U.S. House of Representatives. Health and Human Services Secretary Kathleen Sebelius addressed NCLC attendees in a video message. Sebelius said that chiropractic care has been proven to be effective care that is also cost-effective, and that chiropractic physicians are a vital part of the U.S. health delivery system. Like Harkin, Sebelius called for an end to the current sick care system. ACA President Rick McMichael, DC told attendees, [T]his is about a transformation in health care. This is about our patients and the public we serve. We have a window of opportunityright nowand we must rise to the challenge, take action and persist. Working together as one team with one voice and one message, we can, and we will, help improve health care for America. The Chiropractic Summit and ACA House of Delegates Meeting Following NCLC, Chiropractic Summit XII took place on Feb. 16. First convened in September 2007, the Chiropractic Summit represents leadership from more than 40 organizations within the profession. With the common goal of advancing chiropractic, the Summit meets regularly to collaborate, seek solutions and support collective action to address challenges facing the profession. Each year NCLC is held in conjunction with an official business meeting of the ACA House of Delegates (HOD). ACA President Dr. Rick McMichael presided over both meetings and opened each with praise for the profession for working together to address critical issues. Additional coverage of both NCLC and the House of Delegates meeting will be available in the April 2011 issue of ACA News, the associations flagship publication. A selection of photographs from the meetings can be found on the ACA Web site at www.acatoday.org/Gallery. The American Chiropractic Association (ACA), based in Arlington, Va., is the largest professional association in the United States representing doctors of chiropractic. ACA promotes the highest standards of patient care and ethics, and supports research that contributes to the health and well-being of millions of chiropractic patients. Visit www.acatoday.org.